Sick and Tired: Understanding and Managing Sleep Difficulties in ...
Sick and Tired: Understanding and Managing Sleep Difficulties in ...
Sick and Tired: Understanding and Managing Sleep Difficulties in ...
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Logistic Regression<br />
As 97% of the sample revealed a PSQI score of >6 (the cut-off score) used by the PSQI,<br />
the sample was split <strong>in</strong>to two groups based on the median score to <strong>in</strong>dicate those<br />
experienc<strong>in</strong>g milder (those scor<strong>in</strong>g 0-13, N= 56) <strong>and</strong> more severe levels of sleep<br />
difficulties (those scor<strong>in</strong>g 14 or above) to enable an exploration of the factors associated<br />
with more severe forms of sleep disturbance. A logistic regression was conducted<br />
enter<strong>in</strong>g <strong>in</strong> the variables; age, gender, positive affect, negative affect, <strong>and</strong> the eight<br />
subscale scores of the RAND SF-36 us<strong>in</strong>g the forward log likelihood method. This<br />
method compares each variable <strong>in</strong> the model <strong>in</strong> the absence <strong>and</strong> presence of other<br />
variables to explore its contribution to the model. Variables not significantly<br />
contribut<strong>in</strong>g to the model are excluded. The f<strong>in</strong>al model with significant predictors is<br />
shown <strong>in</strong> Table 3, reveal<strong>in</strong>g that only the lower quality of life <strong>in</strong> the RAND SF-36<br />
subscale relat<strong>in</strong>g to role difficulties due to emotional problems is significantly<br />
associated with more severe global sleep disturbances.<br />
Table 3. F<strong>in</strong>al model of variables associated with global sleep quality <strong>in</strong> the logistic<br />
regression<br />
B St<strong>and</strong>ard P value Odds 95% Confidence<br />
Error<br />
ratio Intervals<br />
Constant -0.41 .28<br />
Role difficulties due<br />
to emotional problems<br />
-0.2 .01 0.00 0.98 0.97-0.99<br />
As the distribution of health outcomes was negatively skewed on the SF36, participants<br />
could not be classified <strong>in</strong>to those with poor or good health outcomes with<strong>in</strong> this study<br />
consequently, logistic regression was deemed not to be appropriate. Structural equation<br />
modell<strong>in</strong>g offered an analytic approach that would assist <strong>in</strong> explor<strong>in</strong>g the complex<br />
relationships between variables that emerged <strong>in</strong> the correlation analysis. This approach<br />
offers the ability to explore how the variables <strong>in</strong>teract, the validity of the data <strong>and</strong><br />
enables the <strong>in</strong>vestigation of moderat<strong>in</strong>g <strong>and</strong> mediat<strong>in</strong>g variables. However, accord<strong>in</strong>g to<br />
Tabachnick <strong>and</strong> Fidell (2007) prior knowledge of the potential relationships between<br />
variables is needed to apply structured equation modell<strong>in</strong>g. Because this was an<br />
exploratory analysis (due to the fact that the nature of the relationships between<br />
variables is unknown <strong>in</strong> this population) <strong>and</strong> consider<strong>in</strong>g the number of variables that<br />
would need to be entered <strong>in</strong>to the structural equation model, the sample size of this<br />
study was considered to be too small to apply structural equation modell<strong>in</strong>g to the data<br />
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